McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma
Introduction McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown diseas...
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2022-06-01
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| Series: | Journal of Coloproctology |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742255 |
| _version_ | 1811242322959007744 |
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| author | Bruno Augusto Alves Martins Ana Clara Ramalho Gomes Maria Eduarda de Almeida Santos Natascha Mourão Moreira Romulo Medeiros de Almeida João Batista de Sousa |
| author_facet | Bruno Augusto Alves Martins Ana Clara Ramalho Gomes Maria Eduarda de Almeida Santos Natascha Mourão Moreira Romulo Medeiros de Almeida João Batista de Sousa |
| author_sort | Bruno Augusto Alves Martins |
| collection | DOAJ |
| description | Introduction McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management.
Case Report A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma.
Discussion McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder. |
| first_indexed | 2024-04-12T13:49:49Z |
| format | Article |
| id | doaj.art-c6910880e7fd43bb8182b5744b2c58b7 |
| institution | Directory Open Access Journal |
| issn | 2237-9363 2317-6423 |
| language | English |
| last_indexed | 2024-04-12T13:49:49Z |
| publishDate | 2022-06-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Journal of Coloproctology |
| spelling | doaj.art-c6910880e7fd43bb8182b5744b2c58b72022-12-22T03:30:34ZengThieme Revinter Publicações Ltda.Journal of Coloproctology2237-93632317-64232022-06-01420218718910.1055/s-0041-1742255McKittrick-Wheelock Syndrome Secondary to Rectal AdenocarcinomaBruno Augusto Alves Martins0Ana Clara Ramalho Gomes1Maria Eduarda de Almeida Santos2Natascha Mourão Moreira3Romulo Medeiros de Almeida4João Batista de Sousa5Serviço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, BrazilFaculdade de Medicina, Universidade de Brasília, Brasília, DF, BrazilFaculdade de Medicina, Universidade de Brasília, Brasília, DF, BrazilServiço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, BrazilServiço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, BrazilServiço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, BrazilIntroduction McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management. Case Report A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma. Discussion McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742255colorectal neoplasmscolorectal surgerysyndromesacute kidney injuryelectrolyte disturbancechronic diarrhea |
| spellingShingle | Bruno Augusto Alves Martins Ana Clara Ramalho Gomes Maria Eduarda de Almeida Santos Natascha Mourão Moreira Romulo Medeiros de Almeida João Batista de Sousa McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma Journal of Coloproctology colorectal neoplasms colorectal surgery syndromes acute kidney injury electrolyte disturbance chronic diarrhea |
| title | McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma |
| title_full | McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma |
| title_fullStr | McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma |
| title_full_unstemmed | McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma |
| title_short | McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma |
| title_sort | mckittrick wheelock syndrome secondary to rectal adenocarcinoma |
| topic | colorectal neoplasms colorectal surgery syndromes acute kidney injury electrolyte disturbance chronic diarrhea |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742255 |
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